The Comparison of Tunnel Morphology and Graft Healing in Anterior Cruciate Ligament Reconstructions Using Peroneus Longus And Hamstring Tendons

The Comparison of Tunnel Morphology and Graft Healing in Anterior Cruciate Ligament Reconstructions Using Peroneus Longus And Hamstring Tendons

1. Comparison of the grafts using Magnetic Resonance Imaging (MR) to determine whether their maturation and bone integration are different,
2. Comparison of the grafts using Computerized Tomography (CT) to determine whether their effects on the tunnels opened in cruciate ligament reconstruction surgeries are different,
3. In the event that graft healing and effects on the tunnels differ between grafts, determination of whether these differences are related to patient clinics,

The project method; Patients who will be operated with 2 different grafts used in anterior cruciate ligament surgeries will be included in 2 different randomized groups of 29 people (hamstring and peroneus groups) determined by obtaining their informed consent before the surgery and then,

1. The maturation of the grafts will be measured and compared with the SNQ (Signal/Noise quotient) value and the graft-bone integration with the measuring Tendon Bone Healing Grade with the Magnetic Resonance (MR) to be taken at the 1st year controls after the surgery,
2. Changes in tunnel morphology; The volume of the tunnels will be measured with the Computerized Tomography (CT) imaging method to be taken prospectively within the first week after the surgery date and 1 year after the surgery date and the changes within 1 year will be calculated by comparing them.
3. In the outpatient clinic follow-ups of both groups; Knee laxity will be obtained with Lachman, Anterior drawer and Pivot shift tests and knee scores and activity levels will be obtained using IKDC, Lysholm, Marx activity scales and it will be examined whether these data are related to SNQ, Tendon Bone Healing Grade and tunnel expansion.

Inclusion Criteria:

• Patients aged between 18 and 45 years.
• BMI in the range of 18 to 28.
• Diagnosed with an anterior cruciate ligament (ACL) injury preoperatively confirmed by MRI.
• Patients for whom it is deemed appropriate to harvest ipsilateral hamstring tendons or Peroneus Longus tendon for use as a graft.

Exclusion Criteria:

• History of previous surgery on the affected knee or ankle.
• Presence of multiple ligament injuries in the affected knee.
• ACL injuries that occurred more than 12 months prior to surgery.
• Evidence of unstable meniscal injury on preoperative MRI that may alter the -postoperative rehabilitation protocol.
• Inability to obtain a graft diameter of at least 9 mm using the isolated graft.
• Presence of meniscal tears requiring repair.
• Presence of advanced chondral lesions requiring surgical intervention.
• Intraoperative detection of multiple ligament injuries.
• Requirement for additional surgical procedures that would alter the standard rehabilitation protocol.
• Occurrence of intraoperative surgical complications.